19-11. FAMILIAL RELATIONSHIP DISCLOSURE STATEMENT.docx

This is a Familial Relationship Disclosure Statement for the State of Arizona related to a Backflow Prevention Parts & Services contract opportunity. The document serves as a formal disclosure mechanism requiring bidders and contractors to identify any familial relationships between themselves and employees, officials, or representatives of the contracting agency. The disclosure statement is designed to ensure transparency and prevent conflicts of interest in the procurement process for backflow prevention services, which include annual inspections and certifications of fire, domestic, and irrigation devices, as well as repair or replacement services for failed or leaking backflow devices.

The disclosure statement requires contractors to complete and submit the form as part of their bid or contract documentation to maintain compliance with Arizona procurement regulations. This document is a standard requirement intended to verify that no familial relationships exist that could compromise the integrity of the bidding process or the contractor's impartiality in performing backflow prevention services on an as-needed basis. Submission of an accurate and complete familial relationship disclosure statement is typically mandatory for bid consideration and contract award.